POS0940 CHRONIC PAIN IN MULTIPLE SITES AND WIDESPREAD PAIN IS ASSOCIATED WITH VASCULAR AND HEART FUNCTION: A PROSPECTIVE COHORT STUDY
Authors: J. Tian, G. Jones, F. Pan
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Chronic pain is highly prevalent in the general population and has been considered a disease entity in itself. Recent studies including our own have shown that chronic pain in multiple sites was associated with a higher risk of cardiovascular disease (CVD) and the relationship may be causal. Early changes in vasculature and heart function such as arterial stiffness, carotid intima thickness (CIMT), cardiac index (CI) and ventricular ejection fraction (LVEF), have been strong and independent predictors of CVD risk; however, whether chronic pain is associated with early signs of vasculature and heart function changes has not been investigated. <h3>Objectives</h3> To examine the associations of chronic pain in multiple sites and widespread pain with arterial stiffness index (ASI), CIMT, CI and LVEF. <h3>Methods</h3> This study utlised data from the UK biobank study which is a prospective cohort study with over 500,000 participants aged 40–69 years recruited at baseline, and some participants attending the subsquent three followups including two imaging visits. Pain sites (including hip, knee, back, neck/shoulder or 'all over the body') and duration were measured via a questionnaire at each visit. Chronic pain was defined if pain had lasted for ≥3 months. Participants were categorised into six groups: no chronic pain, chronic pain in 1, 2, 3 and 4-site and 'all over the body'. ASI (in m/s) was measured by using finger photoplethysmography at each visit. CIMT, CI and LVEF were assessed at the two imaging visits. CIMT (in micrometres) was measured using ultrasound. CI (in litres/min/m2) and LVEF (in percentage) were obtained from heart MRI. Linear mixed-effects model was used for the analyses. <h3>Results</h3> A total of 97,774, 12,213, 28,326, and 2,903 participants who had complete data were included in the ASI analysis over a median follow-up of 11.4 years (interquartile range [IQR]: 10.6–12.3), while 22,851 and 607 participants were included for CIMT and heart function analyses over a median follow-up of 2.3 years (IQR: 2.2–2.5) (Figure 1). At baseline, the participants were 56.5 [8.1] years (Mean [SD] age) and 51% were females. Greater number of chronic pain sites was associated with a higher ASI and lower LVEF in a dose-response relationship (both P for trends &lt;0.05) after adjustment for all covariates. Participants with chronic pain 'all over the body' had the highest ASI (β=0.24, 95%CI 0.06–0.43) and lowest LVEF (β=-1.21, 95%CI -2.21–-0.22). No statistically significant association was found for CIMT and CI. No significant interaction between chronic pain and follow-up time with all outcomes was observed, indicating that the effect of chronic pain on vasculature and heart function did not change over time. <h3>Conclusion</h3> This study found a dose-response relationship between number of chronic pain sites and ASI and LVEF, with participants with chronic widespread pain having the highest ASI and lowest LVEF. These findings suggest that chronic pain may have a detrimental effect on vasculature and heart function. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.